Scheduling models and primary health care quality

Abstract

OBJECTIVE: To evaluate whether the scheduling model influences the perception of the user about the quality of primary health care centers. METHODS: This is a cross-sectional and population-based study that measured the quality of centers by the Primary Care Assessment Tool (PCATool-Brazil), applied to adult users (n = 409) from 11 health centers in Florianópolis, state of Santa Catarina. Multilevel analysis was used to verify the relationship between the score of general quality of the primary health care and the scheduling model. The independent variables (age, skin color, scheduling model, panel size by primary health team, poverty ratio as income proxy, number of health teams, presence of economically interest areas, number of medical appointments in one year per primary health team, number of people treated in one year per health team), with p < 0.20 were selected for the multilevel model, which was adjusted with aggregates of information from users and health centers. RESULTS: The health center that used advanced access had a general score of 7.04, while those using a weekly carve-out had a score of 6.26; the carve-out every 15 days, score of 5.87; and the traditional carve-out, score of 6.29. CONCLUSIONS: The scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users.

Progress and challenges in potential access to oral health primary care services in Brazil: A population-based panel study with latent transition analysis

“…How to schedule appointments can be considered a factor that enables the individual to use health services directly related to potential access, thus acting as a factor that limits or expands the individual’s ability to use these services [ 26 , 36 ]. In this study, there is an increase in the number of PHC teams that perform full-time scheduling in both shifts and five days a week; this aspect shows a possible expansion of access to oral health services, and it agrees with other studies that indicate that improvements in the scheduling model may increase access to PHC [ 5 , 37 , 54 ].…”

“…For the structure of the health units, variables were selected that reflected elements of human resources, physical structure and organizational structure [ 17 , 33 , 34 ]. For the work process, variables related to the organization of the agenda were selected in order to allow access to the first consultation and the continuity of treatment [ 35 – 37 ], as well as the provision of various health services in the dental office and at home [ 38 , 39 ].…”

Obstacles to the educational praxis of nurses in the Family Health Strategy

“…Against some trends and strategies of work organization, workers want to resume scheduling by life cycle or health conditions in a movement to resist the recently implemented advanced access model. Advanced access practices have a quality effect on PHC services and minimize problems in the territory (11) , but success requires collective engagement and professional availability in readjusting praxis, changes in the organizational culture and in the working process, so that the resumption of scheduling does not cause regressions and impose barriers and restrictions on access to FHS teams. There are, however, severe criticisms of its negative effects, such as the drastic reduction of time for qualified care (quantity x quality) and the subordination of planned activities, of care continuity, health education itself, and health promotion for the greater bond with the community, for example, to attending spontaneous demand (2,10) .…”

Implementation of an improvement cycle in the care of a primary health care

“…Users feel that this waiting time infringes on their right to access healthcare (24) . According to a study (25) , the users' perception of the quality of primary care improves when they have access to care more quickly.…”